The Effect of Mindfulness-Based Cognitive Therapy On Rumination and Intrusive Thoughts in Patients With Bipolar Disorder: Secondary Analyses From a Randomized Controlled Trial

Background: Preliminary evidence suggests that Mindfulness-Based Cognitive Therapy (MBCT) is a promising treatment for bipolar disorder (BD). One of the proposed working mechanisms of MBCT in attenuating depressive symptoms is through the reduction of depressive rumination. In BD the effect of MBCT on rumination is less well studied. The primary aim of this study was to investigate the effect of MBCT on self-reported trait depressive rumination and an experimental state measure of negative intrusive thoughts. On an exploratory note, we investigated the effect of MBCT on positive rumination and positive intrusive thoughts.Methods: The study population consisted of a subsample of bipolar type I or II patients participating in a multicenter randomized controlled trial comparing MBCT + treatment as usual (TAU) (N = 25) to TAU alone (N = 24). Trait depressive rumination (RRS brooding subscale) and negative intrusive thoughts (breathing focus task (BFT)) were assessed at baseline and post-treatment. During the BFT, participants were asked to report negative, positive and neutral intrusive thoughts while focusing on their breathing. Results: Compared to TAU alone, MBCT + TAU resulted in a significant pre- to post-treatment reduction of trait depressive rumination (R2 = 0.16, F(1, 28) = 5.30, p = .029; medium effect size (f2 = 0.19)) and negative intrusive thoughts on the BFT (R2 = .15, F(1, 28) = 4.88, p = .036; medium effect size (f2 = 0.17)). MBCT did not significantly change positive rumination or positive intrusive thoughts on the BFT.Conclusions: MBCT might be a helpful additional intervention to reduce depressive rumination in BD which might reduce risk of depressive relapse or recurrence. Future research is required to replicate our findings and to explore whether this reduction in rumination following MBCT indeed mediates a reduction in depressive symptoms and leads to relapse prevention in BD.

Ruminating oneself to sleep: The moderating role of reappraisal and suppression in the association between rumination and sleep difficulty in a non-clinical sample

Introduction: It is postulated that negative ruminations perpetuate insomnia symptoms by increasing arousal. Less is known about the role of positive rumination. In this study, we set out to test the association between positive and negative ruminations and subjective sleep and ask whether reappraisal and suppression moderate the relationship between rumination types and subjective sleep reports. Methods: 354 participants (59% women), ages 18-50, responded to online questionnaires regarding symptoms of insomnia (Insomnia Severity Index [ISI]), Emotion Regulation Questionnaire that provides separate scales for Reappraisal and Suppression, Negative Rumination (Ruminative Response Scale), Positive Rumination and Dampening (Responses to Positive Affect questionnaire), and general health and demographics.Results: All three rumination types significantly correlated with ISI (Negative Rumination: R=.567; Positive Rumination: R=-.128; Dampening: R=.519). The primary hypothesis was tested using six separate moderation models, where rumination type, emotion regulation style, and an interaction term were predictors and ISI as the outcome variable. The interaction terms of Negative Rumination with Reappraisal (β=-0.03) and Suppression (β=-0.07) were not significant; the interaction terms of Positive Rumination with Reappraisal (β=0.2) and Suppression (β=-0.17) were significant; and the interaction terms of Dampening with Reappraisal (β=-0.11) and Suppression (β=0.10) were significant. Discussion: Positive Rumination weakly and negatively correlated with ISI, but the combination with Reappraisal was associated with worse sleep. By contrast, Dampening was associated with worse subjective sleep, an effect attenuated by both emotion regulation strategies. Finally, Negative Rumination may be a more powerful regulator of emotion, unaffected by attempts to regulate the emotion.

High levels of anxiety and psychological well-being in college students: A dual factor model of mental health approach

Anxiety disorders are prevalent among college students and contribute to problems in social and academic functioning. The primary focus in the anxiety literature has been on symptoms and deficits in functioning rather than psychological well-being. The present study investigated the extent to which high levels of anxiety co-occurred with self-reported psychological well-being using a dual-factor model of mental health approach. Participants (n = 100) were categorized into two groups (high anxiety crossed with low and high life satisfaction), and groups were compared on several psychological well-being indicators. Supporting a dual-factor approach, students reporting high levels of anxiety and life satisfaction reported higher levels of hope, grit, gratitude, self-focused positive rumination, and savoring of positive emotions than students reporting high levels of anxiety and low levels of life satisfaction. Groups did not differ in emotion-focused positive rumination or in dampening of positive emotion. These results highlight well-being heterogeneity within individuals reporting high levels of anxiety, with implications for treatment and prevention efforts.

Age Differences in Negative, but Not Positive, Rumination

Objectives The main objective of this study was to determine whether there are age differences in positive and negative repetitive thought (ie, rumination). Method Young adults (ages 19–39; n = 114) and older adults (ages 60–85; n = 88) completed measures of negative and positive rumination. Bayesian analyses were used to determine whether age differences were present for both negative (young > old) and positive (old > young) rumination. Results There was extremely strong evidence for age differences in negative rumination, with lower scores in older adults. In contrast, the evidence was in favor of the null hypothesis for positive rumination. Discussion Age-related positivity is better characterized as decreased dwelling on the meaning of negative moods, rather than increased attention to positive ones.